This is a competing continuation application for a K24 Mid-Career Investigator Award in Patient-Oriented Research (POR) for Rosalind Ramsey-Goldman, MD, DrPH, and Professor of Medicine in the Division of Rheumatology at Northwesten University Feinberg School of Medicine. The candidate's career has been committed to POR, and mentoring young investigators in the area of systemic lupus erythematosus (SLE), a chronic, inflammatory, autoimmune disease that primarily affects women during their childbearing years. The candidate has focused her research on studying the long-term consequences of disease and has noted important observations related to pregnancy outcome, malignancy risk, bone health, and measurements of disease activity. The PI has mentored college undergraduates, predoctoral and postdoctoral PhD graduate students, medical students, and graduate physicians in fellowship training. She is recognized for her expertise in guiding junior investigators by her emerging leadership roles on center and training grants, stewardship of an international lupus research group, and committee participation in government and lay organizations. The immediate research goals of this award are 1) to continue the ongoing lupus research activities (osteoporosis, cancer, and cardiovascular disease), 2) to participate as a preceptor for trainees' thesis projects for graduate degrees in clinical research, 3) to mentor trainees at various levels in clinical research, and 4) to use the POR program in systemic lupus erythematosus as a model to mentor junior faculty throughout their early career development. The long-term research goal is to study the long-term consequences of disease and to develop prevention strategies for osteoporosis, cancer, and cardiovascular disease in order to improve clinical outcomes and the quality of life for the patient with lupus.